WQ0022785_Monitoring - 11-2021_20220109

Monitoring Report Submittal
Permit Number #*
Name of Facility:*
Month: * November
Report Information
WQ0022785
Lattisville Grove Baptist Church
Type *
NDMR, NDAR-1, NDAR-2, NDMLR
Confirmation Email Address:*
Name of Submitter: *
Signature:
Date of submittal:
Initial Review
Year:* 2021
Upload Document*
LMBC_ND_2111.pdf 259.58KB
PDF Only
Please upload one PDF containing all applicable monitoring reports
(i.e., NDMR, NDAR-1, NDAR-2, NDMLR, GW-59).
[e-mail]
Chad Leinbach
Reviewer: Lloyd, Chloe D
1 /9/2022
This will be filled in automatically

Is the project number correct?* WQ0022785
Is the monitoring report accepted?* Yes No
Regional Office* Raleigh
Accepted Date:
1 /20/2022

NON -DISCHARGE APPLICATION REPORT
SPRAY IRRIGATION SITE(S)
THERE ARE TWO APPLICATION FIELDS PER PAGE. USE ADDITIONAL PAGES AS NEEDED.
PERMIT NUMBER: WQ0022785 MONTH: November
Page of
YEAR: 2021
FACILITY NAME: Lattisville Grove Baptist Church COUNTY: Orange
Formulas:
Daily Loading (inches) = [Volume Applied (gallons) x 0.1336 (cubic feetigallon) x 12 (inchesffoot)] / [Area Sprayed (acres) x 43,560 (square feet/acre)] OR
= Volume Applied (gallons) / [Area Sprayed (acres) x 27,152 (gallons/acre-inch)]
Maximum Hourly Loading (inches) = Daily Loading (inches) / FTime Irrigated (minutes) 160 (minutes/hour)] Monthly Loading (inches) = Sum of Daily Loadings (inches)
12 Month Floating Total (inches) = Sum of this month's Monthly Loading (inches) and previous 11 month's Monthly Loadings (inches)
Average Weekly Loading (inches) = [Monthly Loading (inches/month) / Number of days in the month (days/month)] x 7 (days/week)
Did Irrigation Occur At This Facility:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
Did Irrigation Occur On This Field:
Yes: No:
FIELD NUMBER:
1
FIELD NUMBER:
AREA SPRAYED (acres):
1.04
AREA SPRAYED (acres):
COVER CROP:
Fescue, Rye
COVER CROP:
PERMITTED HOURLY RATE (inches):
0.2
PERMITTED HOURLY RATE (inches):
D
A
T
E
WEATHER CONDITIONS
storage
Lagoon
Free -board
PERMITTED YEARLY RATE (inches):
23.75
PERMITTED YEARLY RATE (inches):
Weather
code*
Temper-ature
at application
Precipita-tion
Volume
Applied
Time
Irri ated
Daily
Loading
Maximum
Hourly
Loading
Volume
Applied
Time
Irrigated
Daily
Loading
Maximum
Hourly
Loading
ff)
inches
feet
gallons
minutes
inches
inches
gallons
minutes
inches
inches
1
NA
0
0
0.00
#DIV/0!
2
NA
0
0
0.00
#DIV/0!
3
C
54
0.47
NA
0
0
0.00
#DIV/0!
4
NA
0
0
0.00
#DIV/0!
5
NA
0
0
0.00
#DIV/0!
6
NA
0
0
0.00
#DIV/0!
7
NA
0
0
0.00
#DIV/0!
8
NA
0
0
0.00
#DIV/0!
9
NA
0
0
0.00
#DIV/0!
10
NA
0
0
0.00
#DIV/0!
11
CI
72
0
NA
0
0
0.00
#DIV/0!
12
NA
0
0
0.00
#DIV/0!
13
NA
0
0
0.00
#DIV/0!
14
NA
0
0
0.00
#DIV/0!
15
NA
0
0
0.00
#DIV/0!
16
NA
0
0
0.00
#DIV/0!
171
C
72
0
NA
0
0
0.00
#DIV/0!
18
NA
0
0
0.00
#DIV/0!
19
NA
0
0
0.00
#DIV/0!
20
NA
0
0
0.00
#DIV/0!
21
NA
0
0
0.00
#DIV/0!
22
C
55
0.3
NA
0
0
0.00
#DIV/0!
23
NA
0
0
0.00
#DIV/0!
241
NA
0
0
0.00
#DIV/0!
25
NA
0
0
0.00
#DIV/0!
26
NA
0
0
0.00
#DIV/0!
27
NA
0
0
0.00
#DIV/0!
28
NA
0
0
0.00
#DIV/0!
29
NA
0
0
0.00
#DIV/0!
30
NA
0
0
0.00
#DIV/0!
311
NA
0
0
0.00
#DIV/0!
Total Gallons/Monthly Loading (inches)
0
0.00
0
0.00
12 Month Floating Total (inches)
; : ; : ; : ; : ; : ; : ;
3.32
Average Weekly Loading (inches)
: ; : ; : ; : ; : ; : ; :
0
0
* Weather Codes: C-clear, PC -partly cloudy, CI -cloudy, R-rain, Sn-snow, SI-sleet
Spray Irrigation Operator in Responsible Charge (ORC): Chad Leinbach Phone: [phone]
ORC Certification Number:
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
23928 Check Box if ORC Has Changed: ❑
C121w";ZG aeyG
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE AND COMPLETE
TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDAR-1 (5/2003)

NON -DISCHARGE APPLICATION REPORT Pageof
SPRAY IRRIGATION SITE(S)
Facility Status:
Please indicate ( by inserting Y(es) or N(o) in the appropriate box ) whether the facility has been compliant
with the following permit requirements: (Note: if a requirement does not apply to your facility put (NA) in the
compliant box. )
1. The application rate(s) did not exceed the limit(s) specified in the permit.
2. Adequate measures were taken to prevent wastewater runoff from the site(s).
3. A suitable vegetative cover was maintained on the site(s) in accordance with the permit.
4. All buffer zones as specified in the permit were maintained during each application.
5. The freeboard in the treatment and/or storage lagoon(s) was not less than the limit(s)
specified in the permit.
Compliant Y,N
Y
0
0
0
NA
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance with its
permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s) taken. Attach
additional sheets if necessary.
This system is getting infiltration during rain events. Chad - ORC
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that all qualified personnel properly gathered and evaluated the information
submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible
for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and
complete. I am aware that there are significant penalties for submitting false information, including the possibility of fines
and imprisonment for knowing violations."
12/29/21
(Signature of Permittee)' Date
Lattisville Grove Baptist Church
(Permittee-Please print or type)
1701 Jimmv Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
Chad Leinbach
(Name of Signing Official -Please print or type)
ORC
(Position or Title)
[phone] 10/31/23
(Phone Number) (Permit Exp. Date)
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 213.0506 (b)(2)(D).
DENR FORM NDAR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Page of
PERMIT NUMBER:
FACILITY NAME:
WQ0022785
Lattisville Grove Baptist Church
MONTH: November
YEAR: 2021
COUNTY: Ora
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Flow Monitoring Point: Effluent: Influent:
Parameter Monitoring Point: Effluent: N Influent: Surface Water (SW):
SW Code/Name:
Was There Effluent Flow For This Month Generated At This Facilit : Yes: JXJ No:
.. .. .
50050
00400
50060
00310
00610
00530
31616
00625
0063000665
000620
00600
D
A
T
E
Operator
Arrival
Time 2400
Clock
Operator
Time On
Site
ORC
on
Site?
Daily Rate (Flow)
into Treatment
System
pH
Residual
Chlorine
BOD-5
20°C
NH3-N
TSS
Fecal
Coliform (Geo
metric Mean")
TKN
Nitrate +
Nitrite
Total
Phosph
orus
Total
Nitrate
as N
Total
Nitrogen
as N
HRS
Y/N
GALLONS
UNITS
UG/L
MG/L
MG/L
MG/L
/100ML
MG/L
MG/L
MG/L
MG/L
MG/L
1
143
2
143
3
11:55
0.5
N
143
7.3
0.25
4
113
5
113
6
113
7
113
s
113
9
113
10
113
11
15:10
0.33
N
113
7.15
0.21
12
83
13
83
14
83
151
1
1 83
16
83
17
16:00
0.75
N
83
7.55
0.18
1s
180
19
180
20
180
21
180
221
14:30
1 0.5
Y
180
7.47
0.33
<2.0
<0.045
<2.5
<1.0
<0.26
2.7
1.4
2.7
1 2.7
23
143
24
143
25
143
26
143
27
143
281
143
143
L29
30
143
31
Average
129.16667
::::::::
0.2425
#DIV/0!
#DIV/0!
#DIV/0!
#NUM!
#DIV/0!
2.7
1.4
2.7
2.7
Daily Maximum
180
7.551
0.33
0
0
0
0
0
2.71
1.41
2.7
2.7
Daily Minimum
83
7.15
0.18
0
0
01
01
0
2.7
1.4
2.71
2.7
Monthly Limit(s)
956 GPD
NA
NA
NA
NA
NAI
NAI
NA
NA
NA
NA
NA
Composite (C) / Grab (G)
G
G
G
G
G
IG
IG
G
G
G
IG
Operator in Responsible Charge (ORC): Chad Lelnbach Grade: SI
Check Box if ORC Has Changed: ❑ ORC Certification Number:
Certified Laboratories (1): Conner Consulting, LLC (Field)
Person(s) Collecting Samples: Chad Leinbach
Mail ORIGINAL and TWO COPIES to:
ATTN: Non -Discharge Compliance Unit
DENR
Division of Water Quality
1617 Mail Service Center
RALEIGH, NC 27699-1617
Phone: [phone]
23928
(2): ENCO, Inc. (Lab)
� �i�
(SIGNATURE OF OPERATOR IN RESPONSIBLE CHARGE)
BY THIS SIGNATURE, I CERTIFY THAT THIS REPORT IS ACCURATE
AND COMPLETE TO THE BEST OF MY KNOWLEDGE.
DENR FORM NDMR-1 (5/2003)

NON DISCHARGE WASTEWATER MONITORING REPORT
Page of
Facility Status:
Please answer the following question:
Compliant (Y,N)
1. Does all monitoring data and sampling frequencies meet permit requirements? OY
If the facility is non -compliant, please explain in the space below the reason(s) the facility was not in compliance
with its permit. Provide in your explanation the date(s) of the non-compliance and describe the corrective action(s)
taken. Attach additional sheets if necessary.
"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that all qualified personnel properly gathered and
evaluated the information submitted. Based on my inquiry of the person or persons who manage the system, or
those persons directly responsible for gathering the information, the information submitted is, to the best of my
knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false information, including the possibility of fines and imprisonment for knowing violations."
C"� Z_a, t 6aev� 12/29/21
(Signature of Permittee)* Date
Lattisville Grove Baptist Church
(Perm ittee-P lease print or type)
1701 Jimmv Ed Road
Hurdle Mills, NC 27541
(Permittee Address)
Parameter Codes:
Chad Leinbach
(Name of Signing Official -Please print or type)
(Position or Title)
[phone]
(Phone Number)
O RC
01002
Arsenic
31504
Coliform, Total
00600
Nitrogen, Total
00929
Sodium
01022
Boron
00094
Conductivity
00630
NO2&NO3
00931
BAR
00310
BOD5
01042
Copper
00620
NO3
00745
Sulfide
01027
Cadmium
00300
Dissolved Oxygen
00556
Oil -Grease
70295
TDS
00916
Calcium
31616
Fecal Coliform
WQ09
PAN (Plant Available)
00010
Temperature
00940
Chloride
01051
Lead
00400
pH
00625
TKN
50060
Chlorine, Total
Residual
00927
Magnesium
32730
Phenols
00680
TOC
71900 Mercury
00665 Phosphorus, Total
00530
TSS/TSR
01034
Chromium
00610
NH3asN
00937
Potassium
00076
Turbidity
00340
COD
01067
Nickel
00545
Settleable Matter
01092
Zinc
10/31 /23
(Permit Exp. Date)
Parameter Code assistance may be obtained by calling the Water Quality Compliance/Enforcement Unit at [phone] ext. 529.
The monthly average for Fecal Coliform is to be reported as a GEOMETRIC mean. Use only the units designated in the reporting facility's
permit for reporting data.
* If signed by other than the permittee, delegation of signatory authority must be on file with the state per 15A NCAC 2B.0506 (b)(2)(D).
DENR FORM NDMR-1 (5/2003)